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Costa JA, Vale S, Cordovil R, Rodrigues LP, Cardoso V, Proença R, Costa M, Neto C, Brito J, Guilherme J, Seabra A. A school-based physical activity intervention in primary school: effects on physical activity, sleep, aerobic fitness, and motor competence. Front Public Health 2024; 12:1365782. [PMID: 38444436 PMCID: PMC10912631 DOI: 10.3389/fpubh.2024.1365782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 02/05/2024] [Indexed: 03/07/2024] Open
Abstract
Objective The "Super Quinas" project evaluated the effectiveness of an intervention program to improve physical activity, aerobic fitness, sleep, and motor competence on children in primary school. Methods The experimental group (n = 19) enrolled in a 12-week intervention program (one more extra-curricular activity class of 60 min per week) compared to the CG (n = 19), all aged 9-10 years. Physical activity (PA) and sleep were measured by accelerometry, and aerobic fitness was measured by Children's Yo-Yo test (YYIR1C) during the 1st week (PRE), the 6th week (DUR), and the 12th week (POST) of the intervention program. Motor Competence in PRE and POST intervention was also assessed by the Motor Competence Assessment (MCA) instrument. Heart rate (HR, assessed using HR monitors), and enjoyment level were recorded during all intervention program classes. A linear mixed model analysis (i.e., within-subject analyses) was performed. Results Comparing the EG and CG in DUR and POST, the EG spent ~18 min and ~ 34 min more time in moderate to vigorous physical activity (MVPA) per day (p < 0.001); had ~44 min and ~ 203 min less sedentary time per day (p < 0.001); performed more 44 and 128 m in the Children's Yo-Yo test compared to CG (p < 0.001) and slept more 17 and 114 min per night (p < 0.001). In POST motor competence was significantly better (27%) in the EG compared to CG (p < 0.001). The %HRmax during the extra-curricular classes ranged between 65 and 81% (i.e., light to moderate intensities), and the enjoyment between fun and great fun. Conclusion Our findings suggest that adding one more extra-curricular activity class of 60 min per week for 12 weeks effectively increased the levels of physical activity, aerobic fitness, sleep duration, and motor competence in children aged 9-10 years.
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Affiliation(s)
- Júlio A. Costa
- Portugal Football School, Portuguese Football Federation, FPF, Oeiras, Portugal
| | - Susana Vale
- Politécnico do Porto - Escola Superior de Educação, Porto, Portugal
- CIAFEL/ITR - Universidade do Porto, Porto, Portugal
| | - Rita Cordovil
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
- Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
| | - Luís P. Rodrigues
- Instituto Politécnico de Viana do Castelo, Escola Superior de Desporto e Lazer, SPRINT, Melgaço, Portugal
| | - Vasco Cardoso
- Portugal Football School, Portuguese Football Federation, FPF, Oeiras, Portugal
| | | | - Manuel Costa
- Portugal Football School, Portuguese Football Federation, FPF, Oeiras, Portugal
| | - Carlos Neto
- Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
| | - João Brito
- Portugal Football School, Portuguese Football Federation, FPF, Oeiras, Portugal
| | - José Guilherme
- Portugal Football School, Portuguese Football Federation, FPF, Oeiras, Portugal
- Faculty of Sport, Centre of Research, Education, Innovation and Intervention in Sport, University of Porto, Porto, Portugal
| | - André Seabra
- Portugal Football School, Portuguese Football Federation, FPF, Oeiras, Portugal
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Schmidt-Andersen P, Stage A, Pouplier A, Bastholm LH, Müller KG, Larsen A, Ness KK, Larsen HB, Christensen J, Fridh MK. Physical capacity in children and adolescents with newly diagnosed cancer: A systematic review and meta-analysis. Pediatr Blood Cancer 2024; 71:e30746. [PMID: 37877893 PMCID: PMC10842329 DOI: 10.1002/pbc.30746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 09/28/2023] [Accepted: 10/15/2023] [Indexed: 10/26/2023]
Abstract
OBJECTIVE To review the body of evidence on cardiorespiratory fitness, muscle strength, and physical performance in children with newly diagnosed cancer, five databases (MEDLINE, Embase, CINAHL, CENTRAL, and Web of Science) were searched on December 19, 2022. METHODS Thirteen studies, embodying 594 participants within 1 month of cancer diagnosis and 3674 healthy controls were included. Eighteen different outcomes on cardiorespiratory fitness (n = 2), muscle strength (n = 5), physical performance (n = 10), and adverse events (n = 1) were analyzed. RESULTS Fifteen out of 17 outcomes on physical capacity showed severe impairments compared with healthy controls. Where possible, random-effects meta-analysis was conducted to synthesize the results. No adverse events were reported related to testing. CONCLUSION Children with cancer have impaired cardiorespiratory fitness, muscle strength, and physical performance within the first month after diagnosis. However, the evidence is based on a small number of studies with large clinical heterogeneity, limiting the certainty of evidence.
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Affiliation(s)
- Peter Schmidt-Andersen
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital—Rigshospitalet, Denmark
- Department of Occupational Therapy and Physiotherapy, Copenhagen University Hospital—Rigshospitalet, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Anna Stage
- Center for Clinical Research and Prevention, Copenhagen University Hospital—Bispebjerg and Frederiksberg, Denmark
| | - Anna Pouplier
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital—Rigshospitalet, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Louise H. Bastholm
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital—Rigshospitalet, Denmark
| | - Klaus G. Müller
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital—Rigshospitalet, Denmark
- Institute of Clinical Medicine, University of Copenhagen, Denmark
| | - Anders Larsen
- University Hospitals Centre for Health Research (UCSF), Copenhagen University Hospital—Rigshospitalet, Denmark
| | - Kirsten K. Ness
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
| | - Hanne B. Larsen
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital—Rigshospitalet, Denmark
- Institute of Clinical Medicine, University of Copenhagen, Denmark
| | - Jan Christensen
- Department of Occupational Therapy and Physiotherapy, Copenhagen University Hospital—Rigshospitalet, Denmark
| | - Martin K. Fridh
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital—Rigshospitalet, Denmark
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Morgado MC, Sousa M, Coelho AB, Vale S, Costa JA, Seabra A. Effects of "Football and Nutrition for Health" program on body composition, physical fitness, eating behaviours, nutritional knowledge, and psychological status among 7 to 10 years school children. Front Pediatr 2023; 11:1251053. [PMID: 38027281 PMCID: PMC10663241 DOI: 10.3389/fped.2023.1251053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Noncommunicable diseases and obesity are between the major health threat due to consumption of unhealthy foods and limited time spent on physical activities, a situation of particular concern among children. Since children spend most of their time at school, this study intends to investigate the effect of a school intervention program, which combines recreational football and nutrition education, on body composition, physical fitness, physical activity, blood pressure and heart rate, eating behaviours, nutritional knowledge, and psychological status in elementary school children. Methods A total of 67 children, between 7 and 10 years old, were allocated into three groups: the Football Group (FG) which held 2 weekly sessions of 60 min of recreational football, the Nutrition and Football Group (NFG) which held 2 sessions per week of 60 min of recreational football plus 60 min of nutritional education and the Control Group (CG) which maintained its usual curriculum. The intervention lasted 12 weeks. All measurements were collected before and after the intervention. Results Intervention groups significantly (p < 0.05) improved BMI Z-score, rest heart rate, horizontal jump and shuttle test, physical activity level, and psychosocial health. The NFG group significantly decreased (p < 0.05) waist-to-height ratio and blood pressure, and significantly increased (p < 0.05) nutritional knowledge, fruit, and fish consumption. While FG significantly decreased (p < 0.05) the percentage of fat mass and significantly increased (p < 0.05) muscle mass and performance in the 20 m sprint. Discussion The results have shown to improve nutritional status, explosive strength, aerobic and neuromuscular fitness, as well as increase the level of physical activity. The nutritional education sessions contributed to increase nutritional knowledge and to improve the consumption of healthy food groups in a ludic-educational way. The "Football and Nutrition for Health" program was able to induce short-term improvements in several health markers, highlighting the role of the school curriculum in children's health.
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Affiliation(s)
- Micaela C. Morgado
- Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
- Portugal Football School (PFS), Portuguese Football Federation (FPF), Cruz Quebrada - Dafundo, Portugal
| | - Mónica Sousa
- CIDEFES, Universidade Lusófona, Lisboa, Portugal
- CINTESIS@RISE, NOVA Medical School (NMS), Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa, Lisboa, Portugal
| | - André B. Coelho
- Research Center for Sport and Physical Activity (CIDAF), Faculty of Sports Science and Physical Education, University of Coimbra, Coimbra, Portugal
| | - Susana Vale
- Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
- Porto School of Education, Polytechnic Institute of Porto, Porto, Portugal
| | - Júlio A. Costa
- Portugal Football School (PFS), Portuguese Football Federation (FPF), Cruz Quebrada - Dafundo, Portugal
| | - André Seabra
- Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
- Portugal Football School (PFS), Portuguese Football Federation (FPF), Cruz Quebrada - Dafundo, Portugal
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Burns RD, Bai Y, Byun W, Colotti TE, Pfledderer CD, Kwon S, Brusseau TA. Bidirectional relationships of physical activity and gross motor skills before and after summer break: Application of a cross-lagged panel model. JOURNAL OF SPORT AND HEALTH SCIENCE 2022; 11:244-251. [PMID: 32652233 PMCID: PMC9068551 DOI: 10.1016/j.jshs.2020.07.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 04/17/2020] [Accepted: 06/15/2020] [Indexed: 05/27/2023]
Abstract
BACKGROUND Gross motor skills are postulated to have a bidirectional relationship with physical activity (PA); however, no study has tested this relationship before and after a summer break. The purpose of this study was to examine the bidirectional relationships between school PA and gross motor skills in children before and after a summer break. METHODS Participants were a sample of 440 children recruited from 3 low-income schools (age = 8.9 ± 1.2 years, mean ± SD). PA was assessed as average school-day step counts using Yamax DigiWalker pedometers (Yamasa Tokei Keiki, Tokyo, Japan) worn for 5 consecutive school days. Gross motor skills were assessed using the Test for Gross Motor Development, 3rd edition. Data were collected at 2 timepoints: at the end of spring semester (T1) and at the beginning of the subsequent fall semester (T2). An age- and body mass index-adjusted cross-lagged model was employed to relate T1 school step counts with T2 gross motor skills and T1 gross motor skills with T2 school step counts. RESULTS T1 gross motor skills significantly predicted T2 school step counts (β = 0.24, 95 % confidence interval (95%CI): 0.08-0.40, p = 0.003); however, T1 school step counts did not predict T2 gross motor skills (β = 0.04, 95%CI: -0.06 to 0.14, p = 0.445). The model explained 35.4% and 15.9% of the variances of T2 gross motor skills and T2 school step counts, respectively. Additional analyses indicated that these relationships were driven primarily by ball skills. CONCLUSION The relationship between gross motor skills and school PA was not bidirectional; however, higher gross motor skills, specifically ball skills, predicted higher school PA after a 3-month summer break.
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Affiliation(s)
- Ryan D Burns
- Department of Health, Kinesiology, and Recreation, University of Utah, Salt Lake City, UT 84112, USA.
| | - Yang Bai
- Department of Health, Kinesiology, and Recreation, University of Utah, Salt Lake City, UT 84112, USA
| | - Wonwoo Byun
- Department of Health, Kinesiology, and Recreation, University of Utah, Salt Lake City, UT 84112, USA
| | - Taylor E Colotti
- Department of Health, Kinesiology, and Recreation, University of Utah, Salt Lake City, UT 84112, USA
| | - Christopher D Pfledderer
- Department of Health, Kinesiology, and Recreation, University of Utah, Salt Lake City, UT 84112, USA
| | - Sunku Kwon
- Department of Health, Kinesiology, and Recreation, University of Utah, Salt Lake City, UT 84112, USA
| | - Timothy A Brusseau
- Department of Health, Kinesiology, and Recreation, University of Utah, Salt Lake City, UT 84112, USA
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Clustering of cardiometabolic risk factors and the continuous cardiometabolic risk score in children from Southern Brazil: a cross-sectional study. J Diabetes Metab Disord 2021; 20:1221-1228. [PMID: 34900773 DOI: 10.1007/s40200-021-00845-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 06/21/2021] [Indexed: 10/20/2022]
Abstract
Purpose The present study aimed to verify the clustering of cardiometabolic risk factors for cardiovascular diseases (CVD) and its relationship with the continuous cardiometabolic risk score (cMetS). Methods Cross-sectional study with 631 children aged 6 to 9 years. Cardiorespiratory fitness, glucose, systolic blood pressure, total cholesterol/high-density lipoprotein cholesterol ratio, triglycerides, and waist circumference were assessed. The number of children in whom the risk factors were not independently distributed was analyzed. Z-scores were computed for each risk factor to calculate the cMetS. Results There was a high proportion of children with clustering of risk factors for CVD. The clustering of risk factors was apparent in 11.3% of the children for four or more risk factors, and 21.9% had three or more risk factors. The cMetS showed a linear relationship with the increase in the number of risk factors. A cMetS value higher than 0.91 indicated clustering of cardiometabolic risk factors amongst children. Conclusion The use of clustering of cardiometabolic risk factors identified a high proportion of children with the presence of relevant cardiometabolic alterations. A cMetS value higher than 0.91 (relative to an international standard) indicated higher clustering of cardiometabolic risk factors amongst children. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-021-00845-9.
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Silveira JFDC, Welser L, de Borba Schneiders L, da Silva PT, Paiva DN, Hobkirk JP, Carroll S, Reuter CP. Associations of higher TV viewing and low levels of cardiorespiratory fitness with cardiometabolic risk in children and adolescents. SPORT SCIENCES FOR HEALTH 2021. [DOI: 10.1007/s11332-021-00843-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Cardiorespiratory fitness and physical performance after childhood hematopoietic stem cell transplantation: a systematic review and meta-analysis. Bone Marrow Transplant 2021; 56:2063-2078. [PMID: 34155356 DOI: 10.1038/s41409-021-01370-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 05/17/2021] [Accepted: 05/27/2021] [Indexed: 02/05/2023]
Abstract
The effects of childhood hematopoietic stem cell transplantation (HSCT) on key organs can impair cardiorespiratory fitness, muscle strength, and physical performance. We aimed to provide an overview of childhood HSCT survivors' status on these parameters compared with healthy controls and discuss current insights into clinical risk factors. We performed a systematic search in six scientific databases, including studies published before April 2019 and performed a meta-analysis on cardiorespiratory fitness. Muscle strength and physical performance status were presented narratively. We included ten studies embodying 517 childhood HSCT survivors (mean 17.8 years at follow-up). The meta-analysis (n = 4 studies) showed that childhood HSCT survivors have lower cardiorespiratory fitness compared with healthy controls (Standard mean difference (SMD) -1.32 [95% CI -1-58 to -1.07]; I2 2%, p < 0.00001). Collectively, the studies indicated that childhood HSCT survivors have lower muscle strength (n = 4 studies) and physical performance (n = 3 studies) compared with healthy controls. Childhood HSCT survivors have impaired cardiorespiratory fitness years after ended treatment. Muscle strength and physical performance seem to be impaired, although these measures are insufficiently investigated. Associations between HSCT-specific clinical risk factors and cardiorespiratory fitness, muscle strength, and physical performance are required.
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Brand C, de Lucena Martins CM, Dias AF, Fochesatto CF, García-Hermoso A, Honório R, Mota J, Gaya ACA, Gaya AR. Multicomponent intervention effect on cardiometabolic risk factors among overweight/obese Brazilian children: a mediation analysis. SPORT SCIENCES FOR HEALTH 2021. [DOI: 10.1007/s11332-020-00666-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Physical Activity, Cardiorespiratory Fitness and Clustered Cardiovascular Risk in South African Primary Schoolchildren from Disadvantaged Communities: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18042080. [PMID: 33669905 PMCID: PMC7924629 DOI: 10.3390/ijerph18042080] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/10/2021] [Accepted: 02/17/2021] [Indexed: 11/17/2022]
Abstract
The coexistence of multiple cardiovascular risk factors has been reported in school-aged children from the age of nine years, but most evidence stems from high-income countries. This cross-sectional study aimed at describing the cardiovascular health risk, physical activity (PA) behavior and cardiorespiratory fitness (CRF) levels of South African primary schoolchildren, and at examining the associations between PA/CRF and a composite measure of cardiovascular risk. Cross-sectional data from 832 primary schoolchildren (grade 1–4) were analyzed. Total cholesterol/HDL ratio, triglycerides, systolic/diastolic blood pressure, body fat, and glycated hemoglobin were assessed as cardiovascular risk markers. Data were analyzed via mixed linear regressions and analyses of covariance. Overall, 24.2% of the participants did not meet current PA standards. Higher CRF/PA were associated with lower body fat and lower clustered cardiovascular risk (p < 0.05). When categorizing children into CRF/PA quartiles, a lower clustered cardiovascular risk gradient was found in children with higher CRF (p < 0.05) or PA (p < 0.05). Our data shows that higher CRF/PA is associated with lower clustered cardiovascular risk already from a young age. Given that clustered cardiovascular risk present during childhood can track into adulthood, we advocate for PA participation and a healthy weight from a young age onwards.
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Musa DI, Toriola AL, Goon DT, Jonathan SU. Association of Fitness and Fatness with Clustered Cardiovascular Disease Risk Factors in Nigerian Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5861. [PMID: 32823494 PMCID: PMC7459652 DOI: 10.3390/ijerph17165861] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 07/02/2020] [Accepted: 07/03/2020] [Indexed: 12/22/2022]
Abstract
Purpose: This study examinedthe independent and joint association of fitness and fatness with clustered cardiovascular disease risk (CVDrs) in 11-18 year-old Nigerian adolescents. Methods: A hundred and ninety seven adolescents (100 girls and 97 boys) were evaluated forfitness, fatness and CVDrs. Fitness was evaluated with the progressive aerobic cardiovascular endurance run test while fatness was assessed using body mass index. A clustered CVDrs was computed from the standardized residuals of total cholesterol, high density lipoprotein cholesterol, Low density lipoprotein cholesterol, triglycerides, plasma glucose, systolic blood pressure, and diastolic blood pressure. Regression models controlling for waist circumference assessed the association of fitness and fatness with CVDrs. Results: Prevalence of clustered CVD risk was 7.1% (girls = 3.0%; boys = 4.1%). Based on risk factor abnormalities, 52.8% of participants had one or more CVD risk factor abnormalities with more boys (27.4%) affected. Low fitness was associated with clustered CVDrs in both girls (R2 = 9.8%, β = -0.287, p = 0.05) and boys (R2 = 17%, β = -0.406, p < 0.0005). Fatness was not associated with the CVDrs in both sexes. After controlling for all the variables in the model, only fitness (R2 = 10.4%) and abdominal fat (R2 = 19.5%) were associated with CVDrs respectively. Unfit girls were 3.2 (95% CI = 1.31-7.91, p = 0.011) times likely to develop CVD risk abnormality compared to their fit counterparts. The likelihood of unfit boys developing CVD risk abnormality was 3.9 (95% CI = 1.15-10.08, p = 0.005) times compared to their fit peers. Conclusions: Fitness but not fatness was a better predictor of CVDrs in Nigerian boys and girls. The result of this study suggests that any public health strategies aimed at preventing or reversing the increasing trends of CVD risk in adolescents should emphasize promotion of aerobic fitness.
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Affiliation(s)
- Danladi I. Musa
- Department of Human Kinetics and Health Education, Kogi State University, Anyigba 272102, Nigeria
| | - Abel L. Toriola
- Department of Sport, Rehabilitation and Dental Sciences, Tshwane University of Technology, Pretoria 0001, South Africa;
| | - Daniel T. Goon
- Faculty of Health Sciences, University of forte Hare, East London 5201, South Africa;
| | - Sunday U. Jonathan
- Department of Human Kinetics and Health Education, Ibrahim BadamasiBabangida University, Lapai 911101, Nigeria;
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Nielsen MKF, Christensen JF, Frandsen TL, Thorsteinsson T, Andersen LB, Christensen KB, Wehner PS, Hasle H, Adamsen LØ, Schmiegelow K, Larsen HB. Effects of a physical activity program from diagnosis on cardiorespiratory fitness in children with cancer: a national non-randomized controlled trial. BMC Med 2020; 18:175. [PMID: 32624004 PMCID: PMC7336676 DOI: 10.1186/s12916-020-01634-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 05/14/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Children with cancer experience impaired cardiorespiratory fitness and physical function during and after treatment restricting their possibilities to engage in social activities including sport, leisure activities, and school. The objectives were to determine the effects of classmate-supported, controlled, supervised, in-hospital, physical activity program to preserve cardiorespiratory fitness and physical function from time of diagnosis in children with cancer. METHODS National non-randomized controlled trial including schoolchildren aged 6-18 years at diagnosis treated with chemo-/radiotherapy. We included 120 of 128 eligible patients (94%) in the intervention group (62.5% boys, 11.2 ± 3.1 years) from East Denmark and 58 patients in the control group (57% boys, 11.0 ± 3.2 years) from West Denmark. Eight children from the control group withdrew from participation. The groups were comparable in anthropometrics and cancer diagnoses (p > 0.05). The intervention consisted of (i) supervised in-hospital physical activity from diagnosis and throughout intensive treatment, (ii) 90-min general educational session on cancer and therapy in the child's school class, and (iii) selection of two classmates as ambassadors who took turns to support the child's physical training during the daytime. The primary outcome was cardiorespiratory fitness (VO2peak, mL/min/kg) at 6 months after diagnosis (sex, age, diagnosis adjusted). Secondary outcomes were sit-to-stand, timed-up-and-go, handgrip strength, and balance test scores. RESULTS Ambassadors were identified for all, and 2542 individual and 621 group training sessions were held. VO2peak deteriorated over time in the control group (- 0.17 [95% CI - 0.32 to - 0.02] per week, p = 0.02), but not in the intervention group (p = 0.14). At 6 months from diagnosis, VO2peak was higher in the intervention group (29.6 ± 5.6 mL/kg/min) than in the control group (22.1 ± 5.6 mL/kg/min) (p = 0.01), and the intervention group had a better physical function at 3 and 6 months (p < 0.0001). CONCLUSIONS Peer-supported, supervised, in-hospital, physical activity is safe and feasible in children with cancer during treatment. Further, the results suggest that the intervention might mitigate impairments in cardiorespiratory fitness during treatment in children with cancer. TRIAL REGISTRATION The study was prospectively registered on the 11 January 2013. Clinicaltrial.gov NCT01772849 and NCT01772862 .
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Affiliation(s)
- Martin Kaj Fridh Nielsen
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, University Hospital of Copenhagen (Rigshospitalet), Blegdamsvej 9, DK-2100, Copenhagen, Denmark.,The University of Copenhagen, Faculty of Health Science, Institute for Clinical Medicine, Copenhagen, Denmark
| | - Jesper Frank Christensen
- Center for Inflammation and Metabolism/Center for Physical Activity (CIM/CFAS), University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Thomas Leth Frandsen
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, University Hospital of Copenhagen (Rigshospitalet), Blegdamsvej 9, DK-2100, Copenhagen, Denmark
| | - Troels Thorsteinsson
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, University Hospital of Copenhagen (Rigshospitalet), Blegdamsvej 9, DK-2100, Copenhagen, Denmark
| | - Lars Bo Andersen
- Department of Sports Medicine, Norwegian School for Sports Sciences, Oslo, Norway.,Faculty of Education, Arts and Sports, Department of Sport, Food and Natural Sciences,Western Norway University of Applied Sciences, Post box 133, 6851, Sognal, Norway
| | | | - Peder Skov Wehner
- Department of Pediatric Hematology and Oncology, H.C. Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - Henrik Hasle
- Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Lis Ørgaard Adamsen
- Faculty of Health Science, Department of Public Health, Institute for Clinical Medicine, The University of Copenhagen, Copenhagen, Denmark.,The University Hospitals Centre for Health Research (UCSF), University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Kjeld Schmiegelow
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, University Hospital of Copenhagen (Rigshospitalet), Blegdamsvej 9, DK-2100, Copenhagen, Denmark.,The University of Copenhagen, Faculty of Health Science, Institute for Clinical Medicine, Copenhagen, Denmark
| | - Hanne Bækgaard Larsen
- Department of Pediatrics and Adolescent Medicine, The Juliane Marie Center, University Hospital of Copenhagen (Rigshospitalet), Blegdamsvej 9, DK-2100, Copenhagen, Denmark.
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Larsen MN, Madsen M, Nielsen CM, Manniche V, Hansen L, Bangsbo J, Krustrup P, Hansen PR. Cardiovascular adaptations after 10 months of daily 12-min bouts of intense school-based physical training for 8-10-year-old children. Prog Cardiovasc Dis 2020; 63:813-817. [PMID: 32497586 DOI: 10.1016/j.pcad.2020.05.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The present study examined cardiovascular adaptations in 8-10-year-old schoolchildren after a full school year (10 months) of 5 × 12 min/wk. of intense physical training, including small-sided ball games (soccer, basketball and floorball) or interval running. The study involved 8-10-year-old healthy Danish schoolchildren (n = 232), who were cluster-randomized to a small-sided games group (SSG, n = 60), an interval running group (IR, n = 57) or a control group (CON, n = 115). Comprehensive transthoracic echocardiography, resting heart rate and blood pressure measurements were performed at baseline and post intervention. For interval running, analysis of baseline-to-10-months changes showed significant (P < 0.05) between-group differences in delta scores for diastolic blood pressure (BP) and mean arterial BP (IR -3.2 ± 5.7 and - 2.2 ± 6.5 mmHg vs. CON 0.2 ± 5.3 and 0.4 ± 6.4 mmHg, respectively). Delta scores also showed a trend for reduction of mean arterial BP in SSG compared to CON (-2.1 ± 6.0 vs. 0.2 ± 5.3 mmHg, P = 0.067). Moreover, there were between-group differences in delta scores (P < 0.05) for selected echocardiographic parameters, i.e. in SSG vs. CON for interventricular septum thickness and peak transmitral flow velocity in early diastole, and in IR vs. CON for left ventricular systolic diameter. In conclusion, 10 months of 5 × 12 min/wk. of IR in 8-10-year-old children decreased diastolic BP, while both IR and SSG elicited cardiac adaptations. The results suggest that frequent low volume, intense physical training can have effects on the cardiovascular health profile in healthy children.
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Affiliation(s)
- Malte Nejst Larsen
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Department of Nutrition, Exercise and Sports, Copenhagen Centre for Team Sport and Health, University of Copenhagen, Copenhagen, Denmark.
| | - Mads Madsen
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Claus Malta Nielsen
- Department of Nutrition, Exercise and Sports, Copenhagen Centre for Team Sport and Health, University of Copenhagen, Copenhagen, Denmark
| | | | | | - Jens Bangsbo
- Department of Nutrition, Exercise and Sports, Copenhagen Centre for Team Sport and Health, University of Copenhagen, Copenhagen, Denmark
| | - Peter Krustrup
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom
| | - Peter Riis Hansen
- Department of Cardiology, Herlev-Gentofte University Hospital, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
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13
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Exploring Children's Physical Activity Behaviours According to Location: A Mixed-Methods Case Study. Sports (Basel) 2019; 7:sports7110240. [PMID: 31752160 PMCID: PMC6915553 DOI: 10.3390/sports7110240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 11/06/2019] [Accepted: 11/10/2019] [Indexed: 11/23/2022] Open
Abstract
The school environment is ideally placed to facilitate physical activity (PA) with numerous windows of opportunity from break and lunch times, to lesson times and extracurricular clubs. However, little is known about how children interact with the school environment to engage in PA and the other locations they visit daily, including time spent outside of the school environment i.e., evening and weekend locations. Moreover, there has been little research incorporating a mixed-methods approach that captures children’s voices alongside objectively tracking children’s PA patterns. The aim of this study was to explore children’s PA behaviours according to different locations. Sixty children (29 boys, 31 girls)—35 key stage 2 (aged 9–11) and 25 key stage 3 (aged 11–13)—wore an integrated global positioning systems (GPS) and heart rate (HR) monitor over four consecutive days. A subsample of children (n = 32) were invited to take part in one of six focus groups to further explore PA behaviours and identify barriers and facilitators to PA. Children also completed a PA diary. The KS2 children spent significantly more time outdoors than KS3 children (p = 0.009). Boys engaged in more light PA (LPA) when on foot and in school, compared with girls (p = 0.003). KS3 children engaged in significantly more moderate PA (MPA) at school than KS2 children (p = 0.006). Focus groups revealed fun, enjoyment, friends, and family to be associated with PA, and technology, costs, and weather to be barriers to PA. This mixed methodological study highlights differences in the PA patterns and perceptions of children according to age and gender. Future studies should utilize a multi-method approach to gain a greater insight into children’s PA patterns and inform future health policies that differentiate among a range of demographic groups of children.
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14
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Stavnsbo M, Skrede T, Aadland E, Aadland KN, Chinapaw M, Anderssen SA, Andersen LB, Resaland GK. Cardiometabolic risk factor levels in Norwegian children compared to international reference values: The ASK study. PLoS One 2019; 14:e0220239. [PMID: 31425532 PMCID: PMC6699667 DOI: 10.1371/journal.pone.0220239] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 07/11/2019] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE To investigate cardiometabolic risk factor levels in a group of Norwegian 10-year-old children compared to international values and examine the association between cardiorespiratory fitness (CRF) and the reference-standardized clustered risk score. METHODS 913 children (49% girls) were included from the Active Smarter Kids (ASK) study. Body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC) to HDL-C ratio, triglyceride (TG), glucose, insulin, homeostatic model assessment (HOMA) score and CRF, were standardized according to international age-and sex-specific reference values. RESULTS The Norwegian children had significantly more favorable WC, DBP, glucose, HDL-C and CRF levels compared to the international reference values, but similar or less favorable levels of other cardiometabolic risk factors. CRF was the variable that differed the most from the international values (mean (95% CI) 1.20 (1.16 to 1.24) SD). The clustered risk score (excluding CRF) was higher in the Norwegian children, but decreased to below international levels when including CRF (mean (95% CI) - 0.08 (- 0.12 to -0.05) SD). CRF had a significant inverse association with the clustered risk score (excluding CRF) (β - 0.37 SD, 95% CI -0.43 to -0.31). CONCLUSIONS Norwegian children have substantially higher CRF levels than international standards, and including CRF in clustered risk scores reduces overall risk in Norwegian children below that of international levels. CRF is associated with improved cardiometabolic health in children.
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Affiliation(s)
- Mette Stavnsbo
- Department of Sport, Food and Natural Sciences, Western Norway University of Applied Sciences, Sogndal, Norway
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Turid Skrede
- Department of Sport, Food and Natural Sciences, Western Norway University of Applied Sciences, Sogndal, Norway
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Eivind Aadland
- Department of Sport, Food and Natural Sciences, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Katrine N. Aadland
- Department of Sport, Food and Natural Sciences, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Mai Chinapaw
- Department of Public and Occupational Health, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Sigmund A. Anderssen
- Department of Sport, Food and Natural Sciences, Western Norway University of Applied Sciences, Sogndal, Norway
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Lars B. Andersen
- Department of Sport, Food and Natural Sciences, Western Norway University of Applied Sciences, Sogndal, Norway
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Geir K. Resaland
- Center for Physically Active Learning, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
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15
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Mintjens S, Menting MD, Daams JG, van Poppel MNM, Roseboom TJ, Gemke RJBJ. Cardiorespiratory Fitness in Childhood and Adolescence Affects Future Cardiovascular Risk Factors: A Systematic Review of Longitudinal Studies. Sports Med 2019; 48:2577-2605. [PMID: 30144022 PMCID: PMC6182463 DOI: 10.1007/s40279-018-0974-5] [Citation(s) in RCA: 177] [Impact Index Per Article: 35.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Although cardiorespiratory fitness (CRF) in childhood and adolescence may be linked to future cardiovascular health, there is currently limited evidence for a longitudinal association. OBJECTIVES To provide a systematic review on the prospective association between CRF in childhood and adolescence and cardiovascular disease (CVD) risk factors at least 2 years later. METHODS Using a systematic search of Medline, Embase, and SPORTDiscus, relevant articles were identified by the following criteria: generally healthy children and adolescents between 3 and 18 years of age with CRF assessed at baseline, and a follow-up period of ≥ 2 years. The outcome measures were CVD risk factors. We appraised quality of the included articles with STROBE and QUIPS checklists. RESULTS After screening 7524 titles and abstracts, we included 38 articles, assessing 44,169 children and adolescents followed up for a median of 6 years. Eleven articles were of high quality. There was considerable heterogeneity in methodology, measurement of CRF, and outcomes, which hampered meta-analysis. In approximately half of the included articles higher CRF in childhood and adolescence was associated with lower body mass index (BMI), waist circumference, body fatness and lower prevalence of metabolic syndrome in later life. No associations between CRF in childhood and adolescence and future waist-to-hip ratio, blood pressure, lipid profile, and glucose homeostasis were observed. CONCLUSION Although about half of the included articles reported inverse associations between CRF in childhood and adolescence and future BMI, body fatness, and metabolic syndrome, evidence for other CVD risk factors was unconvincing. Many articles did not account for important confounding factors such as adiposity. Recommendations for future research include standardizing the measurement of CRF, i.e. by reporting VO2max, using standardized outcome assessments, and performing individual patient data meta-analyses.
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Affiliation(s)
- Stijn Mintjens
- Department of Pediatrics, Emma Children's Hospital, Amsterdam Reproduction and Development, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1118, Room KTC 4-021, 1081 HZ, Amsterdam, The Netherlands. .,Department of Gynecology and Obstetrics, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam Reproduction and Development, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands.
| | - Malou D Menting
- Department of Gynecology and Obstetrics, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam Reproduction and Development, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands
| | - Joost G Daams
- Medical Library AMC, Amsterdam UMC, University of Amsterdam, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands
| | - Mireille N M van Poppel
- Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.,Institute of Sport Science, University of Graz, Mozartgasse 14, 8010, Graz, Austria
| | - Tessa J Roseboom
- Department of Gynecology and Obstetrics, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam Reproduction and Development, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands
| | - Reinoud J B J Gemke
- Department of Pediatrics, Emma Children's Hospital, Amsterdam Reproduction and Development, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1118, Room KTC 4-021, 1081 HZ, Amsterdam, The Netherlands
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16
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Castro-Piñero J, Perez-Bey A, Cuenca-Garcia M, Cabanas-Sanchez V, Gómez-Martínez S, Veiga OL, Marcos A, Ruiz JR, Gomez-Martinez S, Nova E, Diaz LE, Zapatera B, Veses AM, Hernandez A, Gheorghe A, Castro-Piñero J, Mora-Vicente J, Gonzalez Montesinos JL, Conde-Caveda J, Ruiz JR, Ortega FB, Moledo CP, Baeza AC, Chillon P, del Rosario Fernandez J, Galo AG, Guerra GB, Alfonso AD, Parrilla F, Gomez R, Gavala J, Veiga OL, Villagra HA, del J, Campo, Cordente C, Diaz M, Tejero CM, Acha A, Moya JM, Sanz A, Martinez-Gomez D, Cabanas-Sanchez V, Rodriguez Romo G, Izquierdo R, Garcia-Cervantes L, Esteban-Cornejo I, Bandres F, Lucia A, Santiago C, Gomez-Gallego F. Muscle Fitness Cut Points for Early Assessment of Cardiovascular Risk in Children and Adolescents. J Pediatr 2019; 206:134-141.e3. [PMID: 30413315 DOI: 10.1016/j.jpeds.2018.10.026] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 10/10/2018] [Accepted: 10/12/2018] [Indexed: 01/11/2023]
Abstract
OBJECTIVES To study the cross-sectional and longitudinal (2-year follow-up) association between muscle fitness and cardiovascular disease (CVD) risk factors in youth; whether there are muscle fitness cut points associated with CVD risk (cross-sectional); and whether the health-related muscle fitness cut points identified at baseline are associated with CVD risk 2 years later. STUDY DESIGN In total, 237 children (110 girls) aged 6-10 years and 274 adolescents (131 girls) aged 12-16 years with complete data were included in the study (10.3% drop out). The handgrip strength and the standing long jump tests were used to assess muscle fitness. CVD risk score was computed with sum of 2 skinfolds, systolic blood pressure, insulin, glucose, triglycerides, and total cholesterol/high density lipoprotein cholesterol. RESULTS Muscle fitness at baseline was associated inversely with single CVD risk factors and CVD risk score at baseline and 2-year follow-up (all P < .05). Receiver operating characteristics curve analyses showed a significant discriminating accuracy of handgrip strength in identifying CVD risk in children and adolescents (boys: ≥ 0.367 and ≥0.473; girls: ≥ 0.306 and ≥0.423 kg/kg body mass, respectively, all P < .001). Similarly, the standing long jump cut points for children and adolescents were ≥104.5 and ≥140.5 in boys, and ≥81.5 and ≥120.5 cm in girls, respectively (all P < .05). These cut points were associated with CVD risk 2 years later (all P < .01). CONCLUSIONS Muscle fitness is associated with present and future cardiovascular health in youth, and is independent of cardiorespiratory fitness. It should be monitored to identify youth at risk who could benefit from intervention programs.
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Affiliation(s)
- José Castro-Piñero
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Puerto Real, Spain.
| | - Alejandro Perez-Bey
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Puerto Real, Spain
| | - Magdalena Cuenca-Garcia
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Puerto Real, Spain
| | - Verónica Cabanas-Sanchez
- Department of Physical Education, Sports and Human Movement, Faculty of Teacher Training and Education, Autonomous University of Madrid, Madrid, Spain
| | - Sonia Gómez-Martínez
- Immunonutrition Group, Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council (SCIC), Madrid, Spain
| | - Oscar L Veiga
- Department of Physical Education, Sports and Human Movement, Faculty of Teacher Training and Education, Autonomous University of Madrid, Madrid, Spain
| | - Ascensión Marcos
- Immunonutrition Group, Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council (SCIC), Madrid, Spain
| | - Jonatan R Ruiz
- PROmoting FITness and Health through Physical Activity Research Group (PROFIT), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
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17
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Kamel M, Smith BT, Wahi G, Carsley S, Birken CS, Anderson LN. Continuous cardiometabolic risk score definitions in early childhood: a scoping review. Obes Rev 2018; 19:1688-1699. [PMID: 30223304 DOI: 10.1111/obr.12748] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 06/25/2018] [Accepted: 07/06/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Cardiometabolic risk (CMR) in young children has been measured using various approaches, including a continuous summary score that incorporates components such as adiposity, lipids, metabolic factors and blood pressure. OBJECTIVES The objective of this study was to comprehensively review definitions of continuous CMR scores in children <10 years of age. METHODS A scoping review was conducted using a systematic search of four scientific databases up to June 2016. Inclusion criteria were children <10 years of age and report of a continuous CMR score. RESULTS Ninety-one articles were included. Most studies were published from 2007 to 2016 (96%). Nearly all continuous CMR scores (90%) were calculated using the sum or the mean of z-scores, and many articles age-standardized and sex-standardized components within their own population. The mean number of variables included in the risk scores was 5 with a range of 3-11. The most commonly included score components were waist circumference (52%), triglycerides (87%), high-density lipoprotein cholesterol (67%), glucose (43%) and systolic blood pressure (52%). IMPORTANCE Continuous CMR scores are emerging frequently in the child health literature and are calculated using numerous methods with diverse components. This heterogeneity limits comparability across studies. A harmonized definition of CMR in childhood is needed.
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Affiliation(s)
- M Kamel
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - B T Smith
- Public Health Ontario, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - G Wahi
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - S Carsley
- Public Health Ontario, Toronto, Ontario, Canada.,Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - C S Birken
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - L N Anderson
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.,Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
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18
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Larsen MN, Nielsen CM, Ørntoft CØ, Randers MB, Manniche V, Hansen L, Hansen PR, Bangsbo J, Krustrup P. Physical Fitness and Body Composition in 8-10-Year-Old Danish Children Are Associated With Sports Club Participation. J Strength Cond Res 2018; 31:3425-3434. [PMID: 28445225 PMCID: PMC5704664 DOI: 10.1519/jsc.0000000000001952] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Larsen, MN, Nielsen, CM, Ørntoft, CØ, Randers, M, Manniche, V, Hansen, L, Hansen, PR, Bangsbo, J, and Krustrup, P. Physical fitness and body composition in 8–10-year-old Danish children are associated with sports club participation. J Strength Cond Res 31(12): 3425–3434, 2017—We investigated whether physical fitness and body composition in 8–10-year-old Danish children are associated with sports club participation. The study included 423 schoolchildren, comprising 209 girls and 214 boys, of whom 67 and 74%, respectively, were active in sports clubs. Yo-Yo intermittent recovery level 1 for children (YYIR1C), balance, jump and coordination tests, together with dual-energy X-ray absorptiometry, were used to determine exercise capacity and body composition. Children active in sports clubs had better (p < 0.05) YYIR1C (33%, 767 ± 26 vs. 575 ± 29 m), 20-m sprint (3%, 4.33 ± 0.03 vs. 4.48 ± 0.04 seconds), coordination (6%, 68 ± 1 vs. 72 ± 1 second), and balance test performances (9%, 19.3 ± 0.5 vs. 21.2 ± 0.7 falls·min−1) and lower fat mass index (16%, 3.8 ± 0.1 vs. 4.5 ± 0.2 kg[fat]·m−2) than children not active in sports clubs. Ball game players had better (p < 0.05) YYIR1C (38%, 925 ± 39 vs. 671 ± 28 m), 20-m sprint (4%, 4.25 ± 0.03 vs. 4.42 ± 0.04 seconds), and coordination test performances (5%, 65 ± 1 vs. 69 ± 1 second), along with higher (p < 0.05) lean body mass (5%, 24.00 ± 0.22 vs. 22.83 ± 0.25 kg) and whole-body BMD (2%, 0.90 ± < 0.01 vs. 0.88 ± <0.01 g·cm−2) compared with children active in other sports. The study showed that 8‒10-year-old Danish children engaged in sports-club activity, especially ball game players, have better exercise capacity and superior body composition compared with children not active in sports clubs.
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Affiliation(s)
- Malte N Larsen
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), University of Southern Denmark, Odense, Denmark.,Department of Nutrition, Exercise and Sports, Copenhagen Center for Team Sport and Health, University of Copenhagen, Copenhagen, Denmark
| | - Claus M Nielsen
- Department of Nutrition, Exercise and Sports, Copenhagen Center for Team Sport and Health, University of Copenhagen, Copenhagen, Denmark.,Departement of Health, Municipality of Frederikssund, Denmark
| | - Christina Ø Ørntoft
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), University of Southern Denmark, Odense, Denmark
| | - Morten B Randers
- Department of Nutrition, Exercise and Sports, Copenhagen Center for Team Sport and Health, University of Copenhagen, Copenhagen, Denmark
| | | | | | - Peter R Hansen
- Department of Cardiology, Herlev-Gentofte University Hospital, Gentofte, Denmark
| | - Jens Bangsbo
- Department of Nutrition, Exercise and Sports, Copenhagen Center for Team Sport and Health, University of Copenhagen, Copenhagen, Denmark
| | - Peter Krustrup
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), University of Southern Denmark, Odense, Denmark.,Department of Cardiology, Herlev-Gentofte University Hospital, Gentofte, Denmark
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19
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Reuter CP, de Mello ED, da Silva PT, Borges TS, Klinger EI, Franke SIR, Valim ARDM. Overweight and Obesity in Schoolchildren: Hierarchical Analysis of Associated Demographic, Behavioral, and Biological Factors. J Obes 2018; 2018:6128034. [PMID: 30254759 PMCID: PMC6145315 DOI: 10.1155/2018/6128034] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Revised: 07/24/2018] [Accepted: 08/12/2018] [Indexed: 11/19/2022] Open
Abstract
Studies focused on the mechanisms involved in the development of obesity in children and adolescents have reported associations between this condition and birth weight, sedentary lifestyle, and hereditary conditions. However, few studies have simultaneously evaluated these factors. This cross-sectional study aims to identify demographic, behavioral, and biological factors associated with overweight/obesity in children and adolescents. 381 schoolchildren aged seven to 17 years were included in the study to evaluate the associations between overweight/obesity and biological factors (including family history of obesity, birth weight, and the fat mass and obesity-associated (FTO) rs9939609 polymorphism), demographic variables (including gender and age), and behavioral variables (including physical activity and/or sports participation). The results of this study showed that there was a lower prevalence of obesity in schoolchildren aged 11-17 years (PR: 0.89; p=0.004). Obesity was more prevalent in children whose father (PR: 1.24; p < 0.001) and maternal grandmother (PR: 1.16; p=0.019) were obese. Higher prevalence rates of obesity were also identified in schoolchildren who were overweight at birth (PR: 1.18; p=0.002) and carriers of the obesity risk genotype (PR: 1.13; p=0.016). Biological factors, such as family history of obesity, overweight at birth, and the presence of the fat mass and obesity-associated rs9939609 polymorphism were associated with the prevalence of obesity in children and adolescents.
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Affiliation(s)
- Cézane P. Reuter
- Physical Education and Health Department, Postgraduate Program in Health Promotion, University of Santa Cruz do Sul (UNISC), 96.815-900 Santa Cruz do Sul, RS, Brazil
| | - Elza D. de Mello
- Postgraduate Program in Child & Adolescent Health, Federal University of Rio Grande do Sul (UFRGS), 90.035-003 Porto Alegre, RS, Brazil
| | - Priscila T. da Silva
- Postgraduate Program in Health Promotion, University of Santa Cruz do Sul (UNISC), 96.815-900 Santa Cruz do Sul, RS, Brazil
| | - Tássia S. Borges
- School of Dentistry, Lutheran University Center of Palmas (CEULP-ULBRA), 77.019-900 Palmas, TO, Brazil
| | - Elisa I. Klinger
- Postgraduate Program in Health Promotion, University of Santa Cruz do Sul (UNISC), 96.815-900 Santa Cruz do Sul, RS, Brazil
| | - Silvia I. R. Franke
- Physical Education and Health Department, Postgraduate Program in Health Promotion, University of Santa Cruz do Sul (UNISC), 96.815-900 Santa Cruz do Sul, RS, Brazil
| | - Andréia R. de M. Valim
- Biology and Pharmacy Department, Postgraduate Program in Health Promotion, University of Santa Cruz do Sul (UNISC), 96.815-900 Santa Cruz do Sul, RS, Brazil
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20
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Castro-Piñero J, Perez-Bey A, Segura-Jiménez V, Aparicio VA, Gómez-Martínez S, Izquierdo-Gomez R, Marcos A, Ruiz JR. Cardiorespiratory Fitness Cutoff Points for Early Detection of Present and Future Cardiovascular Risk in Children: A 2-Year Follow-up Study. Mayo Clin Proc 2017; 92:1753-1762. [PMID: 29157533 DOI: 10.1016/j.mayocp.2017.09.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 09/11/2017] [Accepted: 09/13/2017] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To examine the association between cardiorespiratory fitness (CRF) at baseline and cardiovascular disease (CVD) risk in 6- to 10-year-olds (cross-sectional) and 2 years later (8- to 12-year-olds [longitudinal]) and whether changes with age in CRF are associated with CVD risk in children aged 8 to 12 years. PATIENTS AND METHODS Spanish primary schoolchildren (n=236) aged 6 to 10 years participated at baseline. Of the 23 participating primary schools, 22% (n=5) were private schools and 78% (n=18) were public schools. The dropout rate at 2-year follow-up was 9.7% (n=23). The 20-m shuttle run test was used to estimate CRF. The CVD risk score was computed as the mean of 5 CVD risk factor standardized scores: sum of 2 skinfolds, systolic blood pressure, insulin/glucose, triglycerides, and total cholesterol/high-density lipoprotein cholesterol. RESULTS At baseline, CRF was inversely associated with single CVD risk factors (all P<.05) and CVD risk score at baseline and follow-up (P<.001). Cardiorespiratory fitness cutoff points of 39.0 mL/kg per minute or greater in boys and 37.5 mL/kg per minute or greater in girls are discriminative to identify CVD risk in childhood (area under the curve, >0.85; P<.001) and to predict CVD risk 2 years later (P=.004). Persistent low CRF or the decline of CRF from 6-10 to 8-12 years of age is associated with increased CVD risk at age 8 to 12 years (P<.001). CONCLUSION During childhood, CRF is a strong predictor of CVD risk and should be monitored to identify children with potential CVD risk.
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Affiliation(s)
- José Castro-Piñero
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Puerto Real, Spain.
| | - Alejandro Perez-Bey
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Puerto Real, Spain
| | - Víctor Segura-Jiménez
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Puerto Real, Spain
| | - Virginia A Aparicio
- Department of Physiology, Faculty of Pharmacy, Faculty of Sport Sciences, and Institute of Nutrition and Food Technology, University of Granada, Granada, Spain; Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - Sonia Gómez-Martínez
- Immunonutrition Group, Institute of Food Science, Technology and Nutrition, Spanish National Research Council, Madrid, Spain
| | - Rocio Izquierdo-Gomez
- Research Center, Faculty of Education, Universidad Central de Chile, Santiago, Chile
| | - Ascensión Marcos
- Immunonutrition Group, Institute of Food Science, Technology and Nutrition, Spanish National Research Council, Madrid, Spain
| | - Jonatan R Ruiz
- PROmoting FITness and Health through physical activity research group (PROFIT), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
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21
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Castro-Piñero J, Delgado-Alfonso A, Gracia-Marco L, Gómez-Martínez S, Esteban-Cornejo I, Veiga OL, Marcos A, Segura-Jiménez V. Neck circumference and clustered cardiovascular risk factors in children and adolescents: cross-sectional study. BMJ Open 2017; 7:e016048. [PMID: 28899889 PMCID: PMC5640146 DOI: 10.1136/bmjopen-2017-016048] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE Early detection of cardiovascular disease (CVD) risk factors, such as obesity, is crucial to prevent adverse long-term effects on individuals' health. Therefore, the aims were: (1) to explore the robustness of neck circumference (NC) as a predictor of CVD and examine its association with numerous anthropometric and body composition indices and (2) to release sex and age-specific NC cut-off values to classify youths as overweight/obese. DESIGN Cross-sectional study. SETTING 23 primary schools and 17 secondary schools from Spain. PARTICIPANTS 2198 students (1060 girls), grades 1-4 and 7-10. MEASURES Pubertal development, anthropometric and body composition indices, systolic and diastolic blood pressure (SBP and DBP, respectively), cardiorespiratory fitness, blood sampling triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), glucose and inflammatory markers. Homoeostasis model assessment (HOMA-IR) and cluster of CVD risk factors were calculated. RESULTS NC was negatively associated with maximum oxygen consumption (R2=0.231, P<0.001 for boys; R2=0.018, P<0.001 for girls) and adiponectin (R2=0.049, P<0.001 for boys; R2=0.036, P<0.001 for girls); and positively associated with SBP, DBP, TC/HDL-c, TG, HOMA, complement factors C-3 and C-4, leptin and clustered CVD risk factor in both sexes (R2 from 0.035 to 0.353, P<0.01 for boys; R2 from 0.024 to 0.215, P<0.001 for girls). Moreover, NC was positively associated with serum C reactive protein and LDL-c only in boys (R2 from 0.013 to 0.055, P<0.05). CONCLUSION NC is a simple, low-cost and practical screening tool of excess of upper body obesity and CVD risk factors in children and adolescents. Paediatricians can easily use it as a screening tool for overweight/obesity in children and adolescents. For this purpose, sex and age-specific thresholds to classify children and adolescents as normal weight or overweight/obese are provided.
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Affiliation(s)
- José Castro-Piñero
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Puerto Real, Spain
| | - Alvaro Delgado-Alfonso
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Puerto Real, Spain
| | - Luis Gracia-Marco
- Children’s Health and Exercise Research Centre (CHERC), Sport and Health Sciences, University of Exeter, Exeter, UK
- GENUD 'Growth, Exercise, Nutrition and Development' Research Group, University of Zaragoza, Zaragoza, Spain
| | - Sonia Gómez-Martínez
- Immunonutrition Group, Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain
| | - Irene Esteban-Cornejo
- Department of Physical Education, Sports and Human Movement, Faculty of Teacher Training and Education, Autonomous University of Madrid, Madrid, Spain
- PROFITH "PROmoting FITness and Health through physical activity" Research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Oscar L Veiga
- Department of Physical Education, Sports and Human Movement, Faculty of Teacher Training and Education, Autonomous University of Madrid, Madrid, Spain
| | - Ascensión Marcos
- Immunonutrition Group, Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain
| | - Víctor Segura-Jiménez
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Puerto Real, Spain
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22
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Skrede T, Stavnsbo M, Aadland E, Aadland KN, Anderssen SA, Resaland GK, Ekelund U. Moderate-to-vigorous physical activity, but not sedentary time, predicts changes in cardiometabolic risk factors in 10-y-old children: the Active Smarter Kids Study. Am J Clin Nutr 2017; 105:1391-1398. [PMID: 28381476 DOI: 10.3945/ajcn.116.150540] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 03/15/2017] [Indexed: 11/14/2022] Open
Abstract
Background: Cross-sectional data have suggested an inverse relation between physical activity and cardiometabolic risk factors that is independent of sedentary time. However, little is known about which subcomponent of physical activity may predict cardiometabolic risk factors in youths.Objective: We examined the independent prospective associations between objectively measured sedentary time and subcomponents of physical activity with individual and clustered cardiometabolic risk factors in healthy children aged 10 y.Design: We included 700 children (49.1% males; 50.9% females) in which sedentary time and physical activity were measured with the use of accelerometry. Systolic blood pressure, waist circumference (WC), and fasting blood sample (total cholesterol, high-density lipoprotein cholesterol, triglycerides, glucose, fasting insulin) were measured with the use of standard clinical methods and analyzed individually and as a clustered cardiometabolic risk score standardized by age and sex (z score). Exposure and outcome variables were measured at baseline and at follow-up 7 mo later.Results: Sedentary time was not associated with any of the individual cardiometabolic risk factors or clustered cardiometabolic risk in prospective analyses. Moderate physical activity at baseline predicted lower concentrations of triglycerides (P = 0.021) and homeostatic model assessment for insulin resistance (P = 0.027) at follow-up independent of sex, socioeconomic status, Tanner stage, monitor wear time, or WC. Moderate-to-vigorous physical activity (P = 0.043) and vigorous physical activity (P = 0.028) predicted clustered cardiometabolic risk at follow-up, but these associations were attenuated after adjusting for WC.Conclusions: Physical activity, but not sedentary time, is prospectively associated with cardiometabolic risk in healthy children. Public health strategies aimed at improving children's cardiometabolic profile should strive for increasing physical activity of at least moderate intensity rather than reducing sedentary time. This trial was registered at clinicaltrials.gov as NCT02132494.
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Affiliation(s)
- Turid Skrede
- Department of Teacher Education and Sports, Sogn og Fjordane University College, Sogndal, Norway; and
| | - Mette Stavnsbo
- Department of Teacher Education and Sports, Sogn og Fjordane University College, Sogndal, Norway; and
| | - Eivind Aadland
- Department of Teacher Education and Sports, Sogn og Fjordane University College, Sogndal, Norway; and
| | - Katrine N Aadland
- Department of Teacher Education and Sports, Sogn og Fjordane University College, Sogndal, Norway; and
| | - Sigmund A Anderssen
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Geir K Resaland
- Department of Teacher Education and Sports, Sogn og Fjordane University College, Sogndal, Norway; and
| | - Ulf Ekelund
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
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23
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Aerobic fitness and metabolic health in children: A clinical validation of directly measured maximal oxygen consumption versus performance measures as markers of health. Prev Med Rep 2017; 7:74-76. [PMID: 28593126 PMCID: PMC5458058 DOI: 10.1016/j.pmedr.2017.05.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 04/25/2017] [Accepted: 05/15/2017] [Indexed: 01/14/2023] Open
Abstract
High aerobic fitness is consistently associated with a favorable metabolic health profile in children. However, measurement of oxygen uptake, regarded as the gold standard for evaluating aerobic fitness, is often not feasible. Thus, the aim of the present study was to perform a clinical validation of three measures of aerobic fitness (peak oxygen consumption [VO2peak] and time to exhaustion [TTE] determined from a graded treadmill protocol to exhaustion, and the Andersen intermittent running test) with clustered metabolic health in 10-year-old children. We included 93 children (55 boys and 38 girls) from Norway during 2012–2013 in the study. Associations between aerobic fitness and three different composite metabolic health scores (including lipoprotein subgroup particle concentrations, triglyceride, glucose, systolic blood pressure, and waist-to-height ratio) were determined by regression analyses adjusting for sex. The relationships among the measures of aerobic fitness were r = 0.78 for VO2peak vs. TTE, r = 0.63 for VO2peak vs. the Andersen test, and r = 0.67 for TTE vs. the Andersen test. The Andersen test showed the strongest associations across all markers of metabolic health (r = − 0.45 to − 0.31, p < 0.002), followed by VO2peak (r = − 0.35 to − 0.12, p < 0.256), and TTE (r = − 0.28 to − 0.10, p < 0.334). Our findings indicate that indirect measures of aerobic fitness do not stand back as markers of metabolic health status in children, compared to VO2peak. This is of great importance as good field tests provide opportunities for measuring aerobic fitness in many settings where measuring VO2peak are impossible.
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24
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Thorsteinsson T, Larsen HB, Schmiegelow K, Thing LF, Krustrup P, Pedersen MT, Christensen KB, Mogensen PR, Helms AS, Andersen LB. Cardiorespiratory fitness and physical function in children with cancer from diagnosis throughout treatment. BMJ Open Sport Exerc Med 2017; 3:e000179. [PMID: 28761697 PMCID: PMC5530132 DOI: 10.1136/bmjsem-2016-000179] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2016] [Indexed: 01/13/2023] Open
Abstract
Background Children with cancer experience severe reductions in physical fitness and functionality during and following intensive treatment. This may negatively impact their quality of life. Purpose To describe the physical capacity and functionality of children with cancer during and after treatment as well as the feasibility of physical activity intervention in the Rehabilitation including Social and Physical activity and Education in Children and Teenagers with Cancer study. Patients and methods The study included children diagnosed from January 2013 to April 2016 with paediatric cancer or Langerhans cell histiocytosis, all treated with chemotherapy. Seventy-five of 78 consecutively eligible children (96.2%) were included. Median age was 11 years (range 6‒18). The physical capacity and function were assessed based on testing of physical strength, balance and cardiorespiratory fitness. Children were tested at diagnosis, 3 and 6 months after diagnosis and 1 year after cessation of treatment. The feasibility evaluation was inspired by the criteria for reporting the development and evaluation of complex interventions in healthcare. Results All children participated in the physical intervention programme with no dropouts. Strenuous physical exercise and physiological testing during paediatric cancer treatment was safe and feasible, with only five minor adverse events during the intervention. Cardiorespiratory fitness was significantly lower in children with cancer than norms for healthy age-matched children at diagnosis (difference 19.1 mL/kg/min, 95% CI 15.4 to 22.7; p <0.0001), during treatment 3 and 6 months from diagnosis (difference 21.0 mL/kg/min, 95% CI 17.4 to 24.6; p <0.0001 and difference 21.6 mL/kg/min, 95% CI 17.3 to 25.8; p <0.0001, respectively) and 1 year after cessation of treatment (difference 6.9 mL/kg/min, 95% CI 1.1 to 12.7; p <0.0072). Furthermore, children with cancer experienced a pronounced decline in physical function. Conclusion This study shows that it is safe and feasible to perform strenuous physical exercise and testing during paediatric cancer treatment and that children with cancer have significantly lower physical capacity and functionality than healthy age-matched norms. Trial registration number ClinicalTrials.gov: NCT01772862.
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Affiliation(s)
- Troels Thorsteinsson
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Hanne Baekgaard Larsen
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Kjeld Schmiegelow
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lone Friis Thing
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Peter Krustrup
- Department of Sport and Health Sciences, University of Exeter, College of Life and Environmental Sciences, Exeter, UK.,Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), University of Southern Denmark, Odense, Denmark
| | | | | | - Pernille Rudebeck Mogensen
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,Department of Diabetes and Metabolism, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Anne Sofie Helms
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Lars Bo Andersen
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.,Department of Teacher Education and Sport, Western Norway University of Applied Sciences, Røyrgata, Norway
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25
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Segura-Jiménez V, Parrilla-Moreno F, Fernández-Santos JR, Esteban-Cornejo I, Gómez-Martínez S, Martinez-Gomez D, Marcos A, Castro-Piñero J. Physical fitness as a mediator between objectively measured physical activity and clustered metabolic syndrome in children and adolescents: The UP&DOWN study. Nutr Metab Cardiovasc Dis 2016; 26:1011-1019. [PMID: 27519284 DOI: 10.1016/j.numecd.2016.07.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 07/01/2016] [Accepted: 07/06/2016] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND AIMS The extent to which physical fitness (PF) attenuates or modifies the association between physical activity (PA) and clustered metabolic syndrome risk factors (CMetSRF) is controversial. We aimed: i) To examine the independent and combined association of objectively measured PA and PF with CMetSRF in children and adolescents; ii) To test the mediating effect of PF in the association of PA with CMetSRF. METHODS AND RESULTS A total of 226 children and 256 adolescents participated. Levels of PA (light, moderate, vigorous and moderate-to-vigorous [MVPA]) and PF were measured by accelerometry and ALPHA battery, respectively. Cardiorespiratory and muscular fitness values were combined in a global PF variable. A CMetSRF was computed by assessing the following variables: waist circumference, systolic blood pressure, high-density lipoprotein cholesterol, triglycerides and glucose. In children, the highest vigorous PA (β = -0.193; P = 0.003) and MVPA (β = -0.149; P = 0.025) were individually associated with lower CMetSRF, but these associations were not independent of global PF. In adolescents, the association of moderate (β = -0.123; P = 0.046) and MVPA (β = -0.147; P = 0.024) with CMetSRF was independent of PF. Among unfit adolescents, the higher time they spent in MVPA the lower CMetSRF levels were found (P = 0.032). CONCLUSIONS The results are suggestive of a full mediation of global PF in the association of MVPA and vigorous PA with CMetSRF in children. In adolescents, the association of higher moderate and MVPA with lower CMetSRF was independent of levels of PF, and mediation analyses suggest only a partial mediation of global PF in the association of MVPA with CMetSRF.
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Affiliation(s)
- V Segura-Jiménez
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Cádiz, Spain; Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.
| | - F Parrilla-Moreno
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Cádiz, Spain
| | - J R Fernández-Santos
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Cádiz, Spain
| | - I Esteban-Cornejo
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain; Department of Physical Education, Sports and Human Movement, Autonomous University of Madrid, Madrid, Spain
| | - S Gómez-Martínez
- Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science and Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain
| | - D Martinez-Gomez
- Department of Physical Education, Sports and Human Movement, Autonomous University of Madrid, Madrid, Spain
| | - A Marcos
- Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science and Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain
| | - J Castro-Piñero
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Cádiz, Spain
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26
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Mental and physical skill training increases neurogenesis via cell survival in the adolescent hippocampus. Brain Res 2016; 1654:95-101. [PMID: 27531182 DOI: 10.1016/j.brainres.2016.08.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 08/10/2016] [Accepted: 08/12/2016] [Indexed: 12/30/2022]
Abstract
The adolescent hippocampus produces thousands more new neurons daily than the adult, yet many die within weeks of their generation (Cameron and McCay, 2001; Curlik, DiFeo & Shors, 2014; Shors et al., 2016). Learning new skills can increase their survival. The present study tested the effects of physical skill training on the survival of these newly generated cells in males and female rodents during puberty. Newly generated cells were labeled with BrdU, a marker of cell mitosis, and training began one week later, just as the new cells begin to die. Significantly more BrdU-labeled cells were present in the hippocampus of both sexes after engaging in the physical training experiences. The young animals were able to maintain their balance on a modified rotarod task throughout most trials of training and as a consequence expended considerable energy and endurance during each training trial. These data suggest that a combination of both exercise and skill training can increase brain plasticity through increases in neurogenesis in the adolescent hippocampus. This finding supports the premise behind a clinical intervention known as MAP Training, which combines mental and physical training to enhance brain health in humans (Shors et al., 2014; Alderman et al., 2016). Although theoretical at this stage, the positive consequences of MAP Training for brain function may be mediated through neurogenesis. This article is part of a Special Issue entitled SI: Adolescent plasticity.
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27
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Tarp J, Brønd JC, Andersen LB, Møller NC, Froberg K, Grøntved A. Physical activity, sedentary behavior, and long-term cardiovascular risk in young people: A review and discussion of methodology in prospective studies. JOURNAL OF SPORT AND HEALTH SCIENCE 2016; 5:145-150. [PMID: 30356550 PMCID: PMC6188740 DOI: 10.1016/j.jshs.2016.03.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Revised: 03/01/2016] [Accepted: 03/03/2016] [Indexed: 05/11/2023]
Abstract
The long-term effects of physical activity (PA) or sedentary behavior on cardiovascular health in young people are not well understood. In this study, we use a narrative format to review the evidence for a prospective association with adiposity and other well-established biological cardiovascular risk factors in healthy young people, considering only studies with at least 2 years of follow-up. PA appears to elicit a long-term beneficial effect on adiposity and particularly markers of cardiovascular health. With adiposity, however, a few studies also reported that higher levels of PA were associated with higher levels of adiposity. Time spent sedentary does not appear to be related to adiposity or markers of cardiovascular health independent of PA. We then discuss the uncertainties in the underlying causal chain and consider a number of alternative modeling strategies, which could improve our understanding of the relationship in future studies. Finally, we consider the current methodology for assessing PA and sedentary time.
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Affiliation(s)
- Jakob Tarp
- Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, Department of Sport Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, Odense 5230, Denmark
- Corresponding author.
| | - Jan Christian Brønd
- Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, Department of Sport Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, Odense 5230, Denmark
| | - Lars Bo Andersen
- Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, Department of Sport Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, Odense 5230, Denmark
- Department of Sports Medicine, Norwegian School of Sport Sciences, Sognsveien 220, Oslo 0806, Norway
| | - Niels Christian Møller
- Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, Department of Sport Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, Odense 5230, Denmark
| | - Karsten Froberg
- Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, Department of Sport Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, Odense 5230, Denmark
| | - Anders Grøntved
- Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, Department of Sport Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, Odense 5230, Denmark
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28
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Ørntoft C, Fuller CW, Larsen MN, Bangsbo J, Dvorak J, Krustrup P. 'FIFA 11 for Health' for Europe. II: effect on health markers and physical fitness in Danish schoolchildren aged 10-12 years. Br J Sports Med 2016; 50:1394-1399. [PMID: 27130927 PMCID: PMC5136709 DOI: 10.1136/bjsports-2016-096124] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2016] [Indexed: 12/19/2022]
Abstract
Objectives To evaluate whether a modified ‘FIFA 11 for Health’ programme for non-communicable diseases had effects on body composition, blood pressure and physical fitness of Danish schoolchildren aged 10–12 years. Design A cluster-randomised controlled study with 7 intervention and 2 control schools. Participants 546 Danish 5th grade municipal schoolchildren allocated to an intervention group (IG; n=402: 11.1±0.4 (±SD) years, 150.1±7.0 cm, 41.3±8.4 kg) and a control group (CG; n=144: 11.0±0.5 years, 151.2±7.8 cm, 41.3±9.0 kg). Intervention As part of the physical education (PE) curriculum, IG carried out 2 weekly 45 min ‘FIFA 11 for Health’ sessions focusing on health issues, football skills and 3v3 games. CG continued regular school PE activities. Measurements of body composition, blood pressure at rest, Yo-Yo intermittent recovery level 1 children's test (YYIR1C), balance, jump and sprint performance were performed before and after the 11-week study period. Results During the 11-week study period, systolic blood pressure (−3.5 vs 0.9 mm Hg), mean arterial blood pressure (−1.9 vs 0.4 mm Hg), body mass index (−0.02 vs 0.13 kg/m2) and body fat percentage (−0.83% vs −0.04%) decreased more (p<0.05) in IG than in CG. Within-group improvements (p<0.05) were observed in IG for 20 m sprint (4.09±0.29 to 4.06±0.28 s) and YYIR1C performance (852±464 to 896±517 m), but these changes were not significantly different from CG, and balance or jump performance remained unchanged in both groups. Conclusions The modified ‘FIFA 11 for Health’ programme has beneficial effects on body composition and blood pressure for Danish schoolchildren aged 10–12 years, thereby providing evidence that this football-based health education programme can directly impact participants' cardiovascular health profile.
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Affiliation(s)
- Christina Ørntoft
- Department of Nutrition, Exercise and Sports, Copenhagen Centre for Team Sport and Health, University of Copenhagen, Copenhagen, Denmark
| | | | - Malte Nejst Larsen
- Department of Nutrition, Exercise and Sports, Copenhagen Centre for Team Sport and Health, University of Copenhagen, Copenhagen, Denmark
| | - Jens Bangsbo
- Department of Nutrition, Exercise and Sports, Copenhagen Centre for Team Sport and Health, University of Copenhagen, Copenhagen, Denmark
| | - Jiri Dvorak
- FIFA Medical Assessment and Research Centre, Zurich, Switzerland.,Schulthess Clinic, Zurich, Switzerland
| | - Peter Krustrup
- Department of Nutrition, Exercise and Sports, Copenhagen Centre for Team Sport and Health, University of Copenhagen, Copenhagen, Denmark.,Faculty of Life and Environmental Sciences, Sport and Health Sciences, University of Exeter, Exeter, UK
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29
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Schmidt MD, Magnussen CG, Rees E, Dwyer T, Venn AJ. Childhood fitness reduces the long-term cardiometabolic risks associated with childhood obesity. Int J Obes (Lond) 2016; 40:1134-40. [PMID: 27102049 DOI: 10.1038/ijo.2016.61] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Revised: 02/17/2016] [Accepted: 02/28/2016] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The objective of this study was to examine whether childhood cardiorespiratory fitness attenuates or modifies the long-term cardiometabolic risks associated with childhood obesity. DESIGN AND METHODS The study consisted of a 20-year follow-up of 1792 adults who participated in the 1985 Australian Schools Health and Fitness Survey when they were 7-15 years of age. Baseline measures included a 1.6-km run to assess cardiorespiratory fitness and waist circumference to assess abdominal adiposity. At follow-up, participants attended study clinics where indicators of Metabolic Syndrome (MetS) (waist circumference, blood pressure, fasting blood glucose and lipids) were measured and cardiorespiratory fitness was reassessed using a submaximal graded exercise test. RESULTS Both high waist circumference and low cardiorespiratory fitness in childhood were significant independent predictors of MetS in early adulthood. The mutually adjusted relative risk of adult MetS was 3.00 (95% confidence interval: 1.85-4.89) for children in the highest (vs lowest) third of waist circumference and 0.64 (95% confidence interval: 0.43-0.96) for children with high (vs low) cardiorespiratory fitness. No significant interaction between waist circumference and fitness was observed, with higher levels of childhood fitness associated with lower risks of adult MetS among those with either low or high childhood waist circumference values. Participants who had both high waist circumference and low cardiorespiratory fitness in childhood were 8.5 times more likely to have MetS in adulthood than those who had low waist circumference and high cardiorespiratory fitness in childhood. Regardless of childhood obesity status, participants with low childhood fitness who increased their relative fitness by adulthood had a substantially lower prevalence of MetS than those who remained low fit. CONCLUSIONS Childhood waist circumference and cardiorespiratory fitness are both strongly associated with cardiometabolic health in later life. Higher levels of cardiorespiratory fitness substantially reduce the risk of adult MetS, even among those with abdominal obesity in childhood.
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Affiliation(s)
- M D Schmidt
- Department of Kinesiology, University of Georgia, Athens, GA, USA.,Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - C G Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.,Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - E Rees
- Department of Kinesiology, University of Georgia, Athens, GA, USA
| | - T Dwyer
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.,George Institute for Global Health, Oxford Martin School and Nuffield Department of Population Health, Oxford University, Oxford, UK
| | - A J Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
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30
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Noonan RJ, Boddy LM, Fairclough SJ, Knowles ZR. Write, draw, show, and tell: a child-centred dual methodology to explore perceptions of out-of-school physical activity. BMC Public Health 2016; 16:326. [PMID: 27080384 PMCID: PMC4832535 DOI: 10.1186/s12889-016-3005-1] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Accepted: 04/07/2016] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Research to increase children's physical activity and inform intervention design has, to date, largely underrepresented children's voices. Further, research has been limited to singular qualitative methods that overlook children's varied linguistic ability and interaction preference. The aim of this study was to use a novel combination of qualitative techniques to explore children's current views, experiences and perceptions of out-of-school physical activity as well as offering formative opinion about future intervention design. METHODS Write, draw, show and tell (WDST) groups were conducted with 35 children aged 10-11 years from 7 primary schools. Data were analysed through a deductive and inductive process, firstly using the Youth Physical Activity Promotion Model as a thematic framework, and then inductively to enable emergent themes to be further explored. Pen profiles were constructed representing key emergent themes. RESULTS The WDST combination of qualitative techniques generated complimentary interconnected data which both confirmed and uncovered new insights into factors relevant to children's out-of-school physical activity. Physical activity was most frequently associated with organised sports. Fun, enjoyment, competence, and physical activity provision were all important predictors of children's out-of-school physical activity. Paradoxically, parents served as both significant enablers (i.e. encouragement) and barriers (i.e. restricting participation) to physical activity participation. Some of these key findings would have otherwise remained hidden when compared to more traditional singular methods based approaches. CONCLUSIONS Parents are in a unique position to promote health promoting behaviours serving as role models, physical activity gatekeepers and choice architects. Given the strong socialising effect parents have on children's physical activity, family-based physical activity intervention may offer a promising alternative compared to traditional school-based approaches. Parents' qualitative input is important to supplement children's voices and inform future family-based intervention design. The WDST method developed here is an inclusive, interactive and child-centred methodology which facilitates the exploration of a wide range of topics and enhances data credibility.
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Affiliation(s)
- Robert J Noonan
- The Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, 62 Great Crosshall Street, Liverpool, L3 2AT, UK.
| | - Lynne M Boddy
- The Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, 62 Great Crosshall Street, Liverpool, L3 2AT, UK
| | - Stuart J Fairclough
- Department of Sport and Physical Activity, Edge Hill University, Ormskirk, UK
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - Zoe R Knowles
- The Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, 62 Great Crosshall Street, Liverpool, L3 2AT, UK
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Zaqout M, Michels N, Bammann K, Ahrens W, Sprengeler O, Molnar D, Hadjigeorgiou C, Eiben G, Konstabel K, Russo P, Jiménez-Pavón D, Moreno LA, De Henauw S. Influence of physical fitness on cardio-metabolic risk factors in European children. The IDEFICS study. Int J Obes (Lond) 2016; 40:1119-25. [PMID: 26857382 DOI: 10.1038/ijo.2016.22] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 11/30/2015] [Accepted: 12/09/2015] [Indexed: 01/02/2023]
Abstract
OBJECTIVE The aim of the study was to assess the associations of individual and combined physical fitness components with single and clustering of cardio-metabolic risk factors in children. SUBJECTS/METHODS This 2-year longitudinal study included a total of 1635 European children aged 6-11 years. The test battery included cardio-respiratory fitness (20-m shuttle run test), upper-limb strength (handgrip test), lower-limb strength (standing long jump test), balance (flamingo test), flexibility (back-saver sit-and-reach) and speed (40-m sprint test). Metabolic risk was assessed through z-score standardization using four components: waist circumference, blood pressure (systolic and diastolic), blood lipids (triglycerides and high-density lipoprotein) and insulin resistance (homeostasis model assessment). Mixed model regression analyses were adjusted for sex, age, parental education, sugar and fat intake, and body mass index. RESULTS Physical fitness was inversely associated with clustered metabolic risk (P<0.001). All coefficients showed a higher clustered metabolic risk with lower physical fitness, except for upper-limb strength (β=0.057; P=0.002) where the opposite association was found. Cardio-respiratory fitness (β=-0.124; P<0.001) and lower-limb strength (β=-0.076; P=0.002) were the most important longitudinal determinants. The effects of cardio-respiratory fitness were even independent of the amount of vigorous-to-moderate activity (β=-0.059; P=0.029). Among all the metabolic risk components, blood pressure seemed not well predicted by physical fitness, while waist circumference, blood lipids and insulin resistance all seemed significantly predicted by physical fitness. CONCLUSION Poor physical fitness in children is associated with the development of cardio-metabolic risk factors. Based on our results, this risk might be modified by improving mainly cardio-respiratory fitness and lower-limb muscular strength.
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Affiliation(s)
- M Zaqout
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - N Michels
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - K Bammann
- Institute for Public Health and Nursing Research, Faculty for Human and Health Sciences, University of Bremen, Bremen, Germany.,Leibniz Institute for Prevention Research and Epidemiology BIPS, Bremen, Germany
| | - W Ahrens
- Leibniz Institute for Prevention Research and Epidemiology BIPS, Bremen, Germany
| | - O Sprengeler
- Leibniz Institute for Prevention Research and Epidemiology BIPS, Bremen, Germany
| | - D Molnar
- Department of Pediatrics, Medical Faculty, University of Pécs, Pécs, Hungary
| | - C Hadjigeorgiou
- Research and Education Institute of Child Health, Strovolos, Cyprus
| | - G Eiben
- Public Health Epidemiology Unit (EPI), Department of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - K Konstabel
- Department of Chronic Diseases, Centre of Behavioural and Health Sciences, National Institute for Health Development, Tallinn, Estonia
| | - P Russo
- Unit of Epidemiology and Population Genetics, Institute of Food Sciences, National Research Council, Avellino, Italy
| | - D Jiménez-Pavón
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
| | - L A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
| | - S De Henauw
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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MacIntosh E, Law B. Should I stay or should I go? Exploring the decision to join, maintain, or cancel a fitness membership. MANAGING SPORT AND LEISURE 2015. [DOI: 10.1080/23750472.2015.1025093] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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33
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Andersen LB, Lauersen JB, Brønd JC, Anderssen SA, Sardinha LB, Steene-Johannessen J, McMurray RG, Barros MVG, Kriemler S, Møller NC, Bugge A, Kristensen PL, Ried-Larsen M, Grøntved A, Ekelund U. A new approach to define and diagnose cardiometabolic disorder in children. J Diabetes Res 2015; 2015:539835. [PMID: 25945355 PMCID: PMC4402570 DOI: 10.1155/2015/539835] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 03/17/2015] [Indexed: 02/06/2023] Open
Abstract
The aim of the study was to test the performance of a new definition of metabolic syndrome (MetS), which better describes metabolic dysfunction in children. Methods. 15,794 youths aged 6-18 years participated. Mean z-score for CVD risk factors was calculated. Sensitivity analyses were performed to evaluate which parameters best described the metabolic dysfunction by analysing the score against independent variables not included in the score. Results. More youth had clustering of CVD risk factors (>6.2%) compared to the number selected by existing MetS definitions (International Diabetes Federation (IDF) < 1%). Waist circumference and BMI were interchangeable, but using insulin resistance homeostasis model assessment (HOMA) instead of fasting glucose increased the score. The continuous MetS score was increased when cardiorespiratory fitness (CRF) and leptin were included. A mean z-score of 0.40-0.85 indicated borderline and above 0.85 indicated clustering of risk factors. A noninvasive risk score based on adiposity and CRF showed sensitivity and specificity of 0.85 and an area under the curve of 0.92 against IDF definition of MetS. Conclusions. Diagnosis for MetS in youth can be improved by using continuous variables for risk factors and by including CRF and leptin.
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Affiliation(s)
- Lars Bo Andersen
- Center of Research in Childhood Health, Department of Sport Sciences and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
- Department of Sports Medicine, Norwegian School of Sport Sciences, Sognsveien 220, 0806 Oslo, Norway
- *Lars Bo Andersen:
| | - Jeppe Bo Lauersen
- Department of Sports Medicine, Norwegian School of Sport Sciences, Sognsveien 220, 0806 Oslo, Norway
| | - Jan Christian Brønd
- Center of Research in Childhood Health, Department of Sport Sciences and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Sigmund Alfred Anderssen
- Department of Sports Medicine, Norwegian School of Sport Sciences, Sognsveien 220, 0806 Oslo, Norway
| | - Luis B. Sardinha
- Exercise and Health Laboratory, CIPER, Fac Motricidade Humana, Universidade de Lisboa, Estrada Dacosth, Cruz-Quebrada, 1499 Lisbon, Portugal
| | | | - Robert G. McMurray
- Department of Exercise and Sport Science, University of North Carolina, 025 Fetzer Gym, CB No. 8700, Chapel Hill, NC 27599-8700, USA
| | - Mauro V. G. Barros
- School of Physical Education, University of Pernambuco, Campus Universitario HUOC-ESEF, Arnobio Marques 310, Santo Amaro, 50.100-130 Recife, PE, Brazil
| | - Susi Kriemler
- Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Hirschengraben 84, 8001 Zürich, Switzerland
| | - Niels Christian Møller
- Center of Research in Childhood Health, Department of Sport Sciences and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Anna Bugge
- Center of Research in Childhood Health, Department of Sport Sciences and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Peter Lund Kristensen
- Center of Research in Childhood Health, Department of Sport Sciences and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Mathias Ried-Larsen
- Center of Research in Childhood Health, Department of Sport Sciences and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
- The Centre of Inflammation and Metabolism and Trygfondens Center for Aktiv Sundhed, Department of Infectious Diseases and CMRC, Rigshospitalet, Faculty of Health Sciences, University of Copenhagen, Tagensvej 20, 2100 Copenhagen, Denmark
| | - Anders Grøntved
- Center of Research in Childhood Health, Department of Sport Sciences and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Ulf Ekelund
- Department of Sports Medicine, Norwegian School of Sport Sciences, Sognsveien 220, 0806 Oslo, Norway
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, University of Cambridge, Hills Road, Cambridge CB2 0QQ, UK
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Newton RL, Marker AM, Allen HR, Machtmes R, Han H, Johnson WD, Schuna JM, Broyles ST, Tudor-Locke C, Church TS. Parent-targeted mobile phone intervention to increase physical activity in sedentary children: randomized pilot trial. JMIR Mhealth Uhealth 2014; 2:e48. [PMID: 25386899 PMCID: PMC4260004 DOI: 10.2196/mhealth.3420] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Revised: 08/27/2014] [Accepted: 09/13/2014] [Indexed: 12/15/2022] Open
Abstract
Background Low levels of moderate-to-vigorous physical activity are associated with adverse health consequences. Objective The intent of the study was to determine the feasibility and efficacy of a 12-week physical activity promotion program targeting children, which was delivered to parents through mobile phones. Methods Potential participants were recruited through advertisements placed in the newspaper, local hospitals and schools, and an email listserv. Sedentary children aged 6-10 years were randomly assigned to a minimal (MIG) or intensive (IIG) intervention group. Parents in the MIG were given a goal to increase (within 1 month) and maintain their child’s activity at 6000 pedometer steps/day above their baseline levels and to monitor their child’s steps daily. Parents in the IIG were given the same steps/day and monitoring goals, in addition to text messages and articles containing additional behavioral strategies (based on the Social Cognitive Theory) designed to promote their child’s physical activity. The intervention components were delivered via mobile phone. Anthropometrics, body composition, and questionnaires were administered in a clinic. Children wore a New Lifestyles pedometer (NL-1000) each day throughout the intervention and parents were to monitor their child’s step counts daily. Results Out of 59 children who screened for the study, a total of 27 children (mean age 8.7, SD 1.4 years; 56%, 15/27 female; 59%, 16/27 African American) were enrolled and completed the study. Overall, 97.90% (2220/2268; 98.20%, 1072/1092 for MIG; 97.60%, 1148/1176 for IIG) of expected step data were successfully entered by the parent or study coordinator. Parents in the MIG and IIG were sent approximately 7 and 13 text messages per week, respectively, averaged over the course of the study. IIG parents accessed an average of 6.1 (SD 4.4) articles over the course of the intervention and accessed a fewer number of articles in the last month compared to the first 2 months of the study (P=.002). Children in both the MIG and IIG significantly increased their physical activity, averaged over 12 weeks, by 1427.6 (SD 583.0; P=.02) and 2832.8 (SD 604.9; P<.001) steps/day above baseline, respectively. The between group difference was not statistically significant (P=.10; effect size=.40), nor was the group by time interaction (P=.57). Regardless of group assignment, children who significantly increased their physical activity reported greater increases in physical activity enjoyment (P=.003). The number of behavioral articles accessed by IIG parents was significantly correlated with change in children’s steps/day (r=.575, P=.04). Changes in children’s steps/day were unrelated to changes in their body composition, mood, and food intake. Conclusions Parent-targeted mobile phone interventions are feasible, yet more intense interventions may be needed to support parents’ efforts to increase their children’s physical activity to levels that approximate national recommendations. Trial Registration Clinicaltrials.gov NCT01551108; http://clinicaltrials.gov/show/NCT01551108 (Archived by WebCite at http://www.webcitation.org/6TNEOzXNX).
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Affiliation(s)
- Robert L Newton
- Pennington Biomedical Research Center, Population and Public Health, Baton Rouge, LA, United States.
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McCormack SE, McCarthy MA, Harrington SG, Farilla L, Hrovat MI, Systrom DM, Thomas BJ, Torriani M, McInnis K, Grinspoon SK, Fleischman A. Effects of exercise and lifestyle modification on fitness, insulin resistance, skeletal muscle oxidative phosphorylation and intramyocellular lipid content in obese children and adolescents. Pediatr Obes 2014; 9:281-91. [PMID: 23801526 PMCID: PMC3808470 DOI: 10.1111/j.2047-6310.2013.00180.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Revised: 04/15/2013] [Accepted: 04/16/2013] [Indexed: 01/05/2023]
Abstract
BACKGROUND Obesity is associated with poor fitness and adverse metabolic consequences in children. OBJECTIVE To investigate how exercise and lifestyle modification may improve fitness and insulin sensitivity in this population. DESIGN AND SUBJECTS Randomized controlled trial, 21 obese (body mass index ≥ 95% percentile) subjects, ages 10 to 17 years. METHODS Subjects were given standardized healthful lifestyle advice for 8 weeks. In addition, they were randomized to an in-home supervised exercise intervention (n = 10) or control group (n = 11). MEASUREMENTS Fasting laboratory studies (insulin, glucose, lipid profile) and assessments of fitness, body composition, skeletal muscle oxidative phosphorylation and intramyocellular lipid content (IMCL), were performed at baseline and study completion. RESULTS Subjects were 13.0 ± 1.9 (standard deviation) years old, 72% female and 44% non-white. Exercise improved fitness (P = 0.03) and power (P = 0.01), and increased IMCL (P = 0.02). HOMA-IR decreased among all subjects in response to lifestyle modification advice (P = 0.01), regardless of exercise training assignment. In univariate analysis in all subjects, change in cardiovascular fitness was associated with change in HOMA-IR. In exploratory analyses, increased IMCL was associated with greater resting energy expenditure (r = 0.78, P = 0.005) and a decrease in fasting respiratory quotient (r = -0.70, P = 0.02) (n = 11). CONCLUSIONS Change in fitness was found to be related to change in insulin resistance in response to lifestyle modification and exercise in obese children. IMCL increased with exercise in these obese children, which may reflect greater muscle lipid oxidative capacity.
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Affiliation(s)
- S. E. McCormack
- Program in Nutritional Metabolism and Neuroendocrine Unit; Massachusetts General Hospital and Harvard Medical School; Boston Massachusetts USA
- Division of Endocrinology; Children's Hospital Boston and Harvard Medical School; Boston Massachusetts USA
- Division of Endocrinology and Diabetes; Children's Hospital of Philadelphia; Philadelphia Pennsylvania USA
| | - M. A. McCarthy
- Program in Nutritional Metabolism and Neuroendocrine Unit; Massachusetts General Hospital and Harvard Medical School; Boston Massachusetts USA
| | - S. G. Harrington
- Program in Nutritional Metabolism and Neuroendocrine Unit; Massachusetts General Hospital and Harvard Medical School; Boston Massachusetts USA
| | - L. Farilla
- Program in Nutritional Metabolism and Neuroendocrine Unit; Massachusetts General Hospital and Harvard Medical School; Boston Massachusetts USA
| | | | - D. M. Systrom
- Pulmonary Division; Brigham and Women's Hospital; Boston Massachusetts USA
| | - B. J. Thomas
- The Division of Musculoskeletal Radiology; Department of Radiology; Massachusetts General Hospital and Harvard Medical School; Boston Massachusetts USA
| | - M. Torriani
- The Division of Musculoskeletal Radiology; Department of Radiology; Massachusetts General Hospital and Harvard Medical School; Boston Massachusetts USA
| | - K. McInnis
- Merrimack College; North Andover Massachusetts USA
| | - S. K. Grinspoon
- Program in Nutritional Metabolism and Neuroendocrine Unit; Massachusetts General Hospital and Harvard Medical School; Boston Massachusetts USA
| | - A. Fleischman
- Program in Nutritional Metabolism and Neuroendocrine Unit; Massachusetts General Hospital and Harvard Medical School; Boston Massachusetts USA
- Division of Endocrinology; Children's Hospital Boston and Harvard Medical School; Boston Massachusetts USA
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Konidari A, Auth MKH, Murphy MH, Cunningham C, Foweather L, Gobbi R, Graves LEF, Hopkins ND, Stratton G, Boddy LM. Assessment of biochemical liver markers, physical activity, fitness and body mass index for a cardiometabolic risk model in childhood. Acta Paediatr 2014; 103:e194-8. [PMID: 24512112 DOI: 10.1111/apa.12591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Revised: 01/29/2014] [Accepted: 02/04/2014] [Indexed: 11/28/2022]
Abstract
AIM The aim of this study was to investigate clustered cardiometabolic risk scores in healthy 10- to 12-year-olds using anthropometric characteristics, measurements of cardiorespiratory fitness (CRF) and physical activity and blood markers of metabolic disease. We also evaluated how including markers of liver cell injury would affect the clustered cardiometabolic risk assessment model. METHODS This cross-sectional study focused on 99 children aged 10-12 years. The main outcome included assessing participants with increased and low cardiometabolic risk factors using a clustered risk score model that incorporated markers implicated in metabolic syndrome pathogenesis. Two clustered risk scores were calculated, one incorporating markers of liver cell injury. RESULTS Children classified as 'increased risk' exhibited significantly lower CRF and higher body mass index Z-scores than their 'low-risk' peers. No significant differences in physical activity were observed. This trend remained unchanged when markers of liver injury were included in the clustered risk assessment model. CONCLUSION The clustered risk score model is a scientifically robust method of cardiometabolic risk assessment, which reiterates the importance of weight reduction and CRF promotion in childhood. Our study did not show a significant contribution of liver injury markers, and further research is needed to evaluate their effect on cardiometabolic risk stratification in childhood.
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Affiliation(s)
- A Konidari
- Department of Paediatric Gastroenterology, Hepatology and Nutrition; Alder Hey Children's NHS Foundation Trust; Liverpool UK
| | - MKH Auth
- Department of Paediatric Gastroenterology, Hepatology and Nutrition; Alder Hey Children's NHS Foundation Trust; Liverpool UK
| | - MH Murphy
- Sport and Exercise Sciences Research Institute; Ulster Sports Academy; University of Ulster; Jordanstown Campus; Newtownabbey Co. Antrim UK
| | - C Cunningham
- Sport and Exercise Sciences Research Institute; Ulster Sports Academy; University of Ulster; Jordanstown Campus; Newtownabbey Co. Antrim UK
| | - L Foweather
- The Physical Activity Exchange; Research Institute for Sport and Exercise Sciences; Liverpool John Moores University; Liverpool UK
| | - R Gobbi
- Department of Health Sciences; Liverpool Hope University; Hope Park; Liverpool UK
| | - LEF Graves
- The Physical Activity Exchange; Research Institute for Sport and Exercise Sciences; Liverpool John Moores University; Liverpool UK
| | - ND Hopkins
- The Physical Activity Exchange; Research Institute for Sport and Exercise Sciences; Liverpool John Moores University; Liverpool UK
| | - G Stratton
- Applied Sports Technology, Exercise and Medicine Research Centre; College of Engineering; Swansea University; Swansea UK
- School of Sports Science, Exercise and Health; The University of Western Australia; Perth WA Australia
| | - LM Boddy
- The Physical Activity Exchange; Research Institute for Sport and Exercise Sciences; Liverpool John Moores University; Liverpool UK
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Farah BQ, Ritti-Dias RM, Balagopal PB, Hill JO, Prado WL. Does exercise intensity affect blood pressure and heart rate in obese adolescents? A 6-month multidisciplinary randomized intervention study. Pediatr Obes 2014; 9:111-20. [PMID: 23447453 DOI: 10.1111/j.2047-6310.2012.00145.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Revised: 11/26/2012] [Accepted: 12/17/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND Aerobic exercise improves cardiovascular health in general, but whether the impact varies with exercise intensity is not clear. OBJECTIVE The aim of the current study was to compare the effects of a high-intensity aerobic exercise training (HIT) vs. a low-intensity aerobic exercise training (LIT) on blood pressure (BP), heart rate (HR) and heart rate variability (HRV) in obese adolescents. METHODS Forty-three (13-18 years) Tanner stage (III-IV) matched obese adolescents were studied in a randomized trial of either HIT (corresponding to the ventilatory threshold I; n = 20) or LIT (corresponding to 20% below the ventilatory threshold I; n = 23) programme for a period of 6 months. All participants also received a multidisciplinary therapy that included nutritional, psychological and clinical counselling. Both HIT and LIT sessions were isocaloric, with energy expenditure set at 350 kcal. BP, HR and HRV were measured along with markers of body adiposity and insulin resistance before and after the respective interventions. RESULTS The participants in both groups had similar physical and clinical characteristics. After the 6-month intervention, systolic, diastolic and mean BP decreased (P < 0.05, for all) similarly in both groups, whereas waist circumference, HR and HRV showed beneficial changes only in the HIT group (P < 0.05). CONCLUSION Aerobic exercise training set at a high intensity compared with the low intensity appears to have additional benefits on abdominal obesity and cardiovascular health in that it enhances the parasympathetic and autonomic modulation of the heart in obese adolescents.
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Affiliation(s)
- B Q Farah
- School of Physical Education, University of Pernambuco, Recife, Pernambuco, Brazil
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Abstract
There have been dramatic increases over the past several decades in the prevalence of childhood obesity and childhood metabolic syndrome in the United States and other industrialized nations. Since the 2 conditions carry negative health implications, both during childhood and later in life, it is important for health care professionals to stay abreast of the current literature relative to both conditions. This review will examine definitional issues, prevalence rates, causative factors, and health consequences associated with childhood obesity and the metabolic syndrome, as well as current thinking regarding prevention and treatment efforts. The review will conclude with recommendations relative to future research needs.
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Affiliation(s)
- Scott Owens
- Department of Health, Exercise Science, and Recreation Management, University of Mississippi, University, Mississippi
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Jiménez-Pavón D, Konstabel K, Bergman P, Ahrens W, Pohlabeln H, Hadjigeorgiou C, Siani A, Iacoviello L, Molnár D, De Henauw S, Pitsiladis Y, Moreno LA. Physical activity and clustered cardiovascular disease risk factors in young children: a cross-sectional study (the IDEFICS study). BMC Med 2013; 11:172. [PMID: 23899208 PMCID: PMC3728104 DOI: 10.1186/1741-7015-11-172] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Accepted: 05/30/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The relevance of physical activity (PA) for combating cardiovascular disease (CVD) risk in children has been highlighted, but to date there has been no large-scale study analyzing that association in children aged ≤9 years of age. This study sought to evaluate the associations between objectively-measured PA and clustered CVD risk factors in a large sample of European children, and to provide evidence for gender-specific recommendations of PA. METHODS Cross-sectional data from a longitudinal study in 16,224 children aged 2 to 9 were collected. Of these, 3,120 (1,016 between 2 to 6 years, 2,104 between 6 to 9 years) had sufficient data for inclusion in the current analyses. Two different age-specific and gender-specific clustered CVD risk scores associated with PA were determined. First, a CVD risk factor (CRF) continuous score was computed using the following variables: systolic blood pressure (SBP), total triglycerides (TG), total cholesterol (TC)/high-density lipoprotein cholesterol (HDL-c) ratio, homeostasis model assessment of insulin resistance (HOMA-IR), and sum of two skinfolds (score CRFs). Secondly, another CVD risk score was obtained for older children containing the score CRFs + the cardiorespiratory fitness variable (termed score CRFs + fit). Data used in the current analysis were derived from the IDEFICS ('Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS') study. RESULTS In boys <6 years, the odds ratios (OR) for CVD risk were elevated in the least active quintile of PA (OR: 2.58) compared with the most active quintile as well as the second quintile for vigorous PA (OR: 2.91). Compared with the most active quintile, older children in the first, second and third quintiles had OR for CVD risk score CRFs + fit ranging from OR 2.69 to 5.40 in boys, and from OR 2.85 to 7.05 in girls. CONCLUSIONS PA is important to protect against clustering of CVD risk factors in young children, being more consistent in those older than 6 years. Healthcare professionals should recommend around 60 and 85 min/day of moderate-to-vigorous PA, including 20 min/day of vigorous PA.
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Affiliation(s)
- David Jiménez-Pavón
- Department of Physiotherapy and Nursing, School of Health Sciences, University of Zaragoza, Zaragoza, Spain.
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Bugge A, El-Naaman B, McMurray RG, Froberg K, Andersen LB. Tracking of clustered cardiovascular disease risk factors from childhood to adolescence. Pediatr Res 2013; 73:245-9. [PMID: 23165452 DOI: 10.1038/pr.2012.158] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Clustering of cardiovascular disease (CVD) risk factors has been found in children as young as 9 y of age. However, the stability of this clustering over the course of childhood has yet to be determined. The purpose of this study was to determine the tracking of clustered CVD risk from young school age through adolescence and to examine differences in tracking between levels of overweight/obesity and cardiorespiratory fitness (VO(2peak)). METHODS Beginning at 6 y, children (n = 434) were measured three times in 7 y. Anthropometrics, blood pressure, and VO(2peak) were measured. Fasting blood samples were analyzed for CVD risk factors. A clustered risk score (z-score) was constructed by adding sex-specific z-scores for blood pressure, homeostatic model assessment (HOMA-IR), triglyceride (TG), skinfolds, and negative values of high-density lipoprotein cholesterol (HDLc) and VO(2peak). RESULTS Significant tracking coefficients were found between clustered z-score at all time intervals (r = 0.514, 0.559, and 0.381 between ages 6-9, 9-13, and 6-13 y, respectively, all P < 0.0001). Tracking was higher for low-fit children, whereas no clear pattern was found for different levels of body fat. CONCLUSION We found that clustered z-score is a fairly stable characteristic through childhood. Implementation of preventive strategies could therefore start at early school age.
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Affiliation(s)
- Anna Bugge
- Centre of Research in Childhood Health, Institute of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
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Abstract
The prevalence of childhood obesity has recently peaked in the USA with ~17% of children considered obese. With the increase in adiposity that occurs with weight gain, a persistent low-grade inflammatory state is created. The most commonly studied inflammatory markers associated with obesity are the cytokines, tumor necrosis factor α and interleukin-6, and the acute-phase reactant, C-reactive protein. Understanding the relation between adiposity and inflammation is an important concept because these inflammatory markers influence insulin sensitivity, glucose metabolism, and atherosclerosis, ultimately leading to impaired health. In addition to obesity, physical inactivity is associated with elevated inflammatory markers. The literature, however, is inconsistent as to whether the association between physical activity and inflammation is independent of adiposity. In some obese children, physical fitness appears to circumvent the increase in inflammatory markers that are associated with obesity. The purpose of this review is to examine the relation between adiposity and inflammatory markers, including potential health implications and the impact of physical activity. We exposed a dearth of literature in understanding the interaction between obesity and physical activity on inflammatory markers, especially in children because their anthropometrics change. This review highlights the necessity for further research to better understand the complexity of the chronic inflammatory state associated with obesity.
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Sex differences in the association between level of childhood interleukin-6 and insulin resistance in adolescence. EXPERIMENTAL DIABETES RESEARCH 2012; 2012:859186. [PMID: 22272193 PMCID: PMC3261468 DOI: 10.1155/2012/859186] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/12/2011] [Revised: 11/08/2011] [Accepted: 11/18/2011] [Indexed: 01/08/2023]
Abstract
The purpose of this study was to determine whether levels of interleukin-6 (IL-6) in childhood are related to insulin resistance in adolescence. Further, to explore how fatness and cardiorespiratory fitness (VO2peak) moderate this relationship. Methods. 292 nine-year-old children (n = 292) were followed for 4 years. Anthropometrics and VO2peak were measured. Fasting blood samples were analyzed for IL-6, insulin, and glucose. Homeostasis model assessment (HOMA-IR) was used as a measure of insulin resistance. Results. For girls but not boys, levels of IL-6 at age 9 yrs correlated with HOMA-IR at age 13 yrs: r = 0.223, P = 0.008. Girls with IL-6 levels within the highest quartile at age 9 yrs had an odds ratio of 3.68 (CI = 1.58–8.57) being in the highest quartile of HOMA-IR four years later. Conclusion. In this cohort, IL-6 levels in childhood were related to insulin resistance in adolescence, but only for girls.
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